Vehicle Release

"*" indicates required fields

Name*

Phone*

Email*

I verify that I am the registered owner of a

Make*

Model*

Color*

VIN #

Company Name (if applicable)

Select one:

I authorize the release of my vehicle to an insurance company for pickup

I authorize the release of my vehicle to the following

If releasing to an individual, please complete the following. The individual picking up the vehicle must show a government issued photo I.D. at the time of pick up.

Full name on their driver’s license*

License Number*

Driver's License State*

Expiration*

Copy of Vehicle release (if applicable)

Select Files

Max. file size: 128 MB.

Upload a copy of registered owner's license *

Select Files

Max. file size: 128 MB.

Upload a copy of individual authorized to pick up my vehicle

Select Files

Max. file size: 128 MB.

Disclaimer: I hereby state that I am legally entitled to the above described vehicle and its contents and assume all responsibility for the same. Southside Wrecker will not assume any liability for a vehicle prior to their physical possession or after their release of the vehicle. Some vehicles require a release from the agency who impounded it. Please verify the vehicle hold has been released or you have a copy of the release before coming to pick up the vehicle.

Signature*

By clicking submit I verify I have read and understand this statement.

Vehicle Release

I verify that I am the registered owner of a

Select one:

If releasing to an individual, please complete the following. The individual picking up the vehicle must show a government issued photo I.D. at the time of pick up.

Copy of Vehicle release (if applicable)

Upload a copy of registered owner's license *

Upload a copy of individual authorized to pick up my vehicle

Industry Affiliates

Maps

Union City

Union City

Maps

Shreveport

Bossier